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How are Medicare benefits changing for 2026?
Changes to 2025 Medicare coverage include a $2,000 cap on Part D out-of-pocket costs, small reductions in the average premium for Medicare Advantage and Part D plans, increases for Medicare Part B and Part A premiums and cost-sharing, and adjustments to income-related premium surcharges for Part B and Part D.
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What is the income-related monthly adjusted amount (IRMAA)?
For 2025, high-income beneficiaries – earning over $106,000 a year – pay an IRMAA surcharge that’s added to their Part B and Part D premiums and determined by income from their income tax returns two years prior.

skilled nursing facility

What is a skilled nursing facility?

skilled nursing facility infographic

What is a skilled nursing facility?

A skilled nursing facility is a medical facility that provides skilled nursing care to patients who need inpatient rehabilitation or nursing services but who do not need the level of care that would be provided in a hospital.1

Original Medicare will pay for a stay in a skilled nursing facility if the enrollee was admitted as a hospital inpatient for at least three nights prior to the stay in the skilled nursing facility (a subsequent skilled nursing facility claim can be covered without another hospital stay, as long as it occurs within 30 days of the first skilled nursing facility stay).2

Medicare will pay the full cost for the first 20 days of skilled nursing facility care (assuming the patient had at least three days of inpatient hospital care before moving to the skilled nursing facility). After that, Medicare coverage will continue for up to 100 total days of skilled nursing facility care, but there’s a daily copay that the patient pays.2 Many Medicare beneficiaries have supplemental coverage from an employer, Medicaid, or a Medigap plan, which will cover some or all of the daily copay costs.

Footnotes

  1. Skilled Nursing Facility” CMS Glossary. Accessed June 24, 2025 
  2. Skilled Nursing Facility Care” Medicare.gov. Accessed June 24, 2025